Provider Demographics
NPI:1710302682
Name:BOWERS, CHRISTINE (OTR/L,CHT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3992 IRISH RUN RD SE
Mailing Address - Street 2:
Mailing Address - City:DENNISON
Mailing Address - State:OH
Mailing Address - Zip Code:44621-9398
Mailing Address - Country:US
Mailing Address - Phone:330-340-8418
Mailing Address - Fax:
Practice Address - Street 1:3992 IRISH RUN RD SE
Practice Address - Street 2:
Practice Address - City:DENNISON
Practice Address - State:OH
Practice Address - Zip Code:44621-9398
Practice Address - Country:US
Practice Address - Phone:330-340-8418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0003360171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor